Hepatitis A

Date Updated: 08/28/2020

Overview

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function.

You're most likely to get hepatitis A from contaminated food or water or from close contact with a person or object that's infected. Mild cases of hepatitis A don't require treatment. Most people who are infected recover completely with no permanent liver damage.

Practicing good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.

Symptoms

Hepatitis A signs and symptoms typically don't appear until you've had the virus for a few weeks. But not everyone with hepatitis A develops them. If you do, hepatitis signs and symptoms can include:

Fatigue
Sudden nausea and vomiting
Abdominal pain or discomfort, especially on the upper right side beneath your lower ribs (by your liver)
Clay-colored bowel movements
Loss of appetite
Low-grade fever
Dark urine
Joint pain
Yellowing of the skin and the whites of your eyes (jaundice)
Intense itching

These symptoms may be relatively mild and go away in a few weeks. Sometimes, however, hepatitis A infection results in a severe illness that lasts several months.

When to see a doctor

Make an appointment with your doctor if you have signs or symptoms of hepatitis A.

Getting a hepatitis A vaccine or an injection of immunoglobulin (an antibody) within two weeks of exposure to hepatitis A may protect you from infection. Ask your doctor or your local health department about receiving the hepatitis A vaccine if:

You've traveled out of the country recently, particularly to Mexico or South or Central America, or to areas with poor sanitation
A restaurant where you recently ate reports a hepatitis A outbreak
Someone close to you, such as a roommate or caregiver, is diagnosed with hepatitis A
You recently had sexual contact with someone who has hepatitis A

Causes

Hepatitis A is caused by a virus that infects liver cells and causes inflammation. The inflammation can affect how your liver works and cause other signs and symptoms of hepatitis A.

The virus most commonly spreads when you eat or drink something contaminated with fecal matter, even just tiny amounts. It does not spread through sneezing or coughing.

Here are some of the specific ways the hepatitis A virus can spread:

Eating food handled by someone with the virus who doesn't thoroughly wash his or her hands after using the toilet
Drinking contaminated water
Eating raw shellfish from water polluted with sewage
Being in close contact with a person who's infected — even if that person has no signs or symptoms
Having sex with someone who has the virus

Risk factors

You're at increased risk of hepatitis A if you:

Travel or work in areas of the world where hepatitis A is common
Attend child care or work in a child care center
Live with another person who has hepatitis A
Are a man who has sexual contact with other men
Have any type of sexual contact with someone who has hepatitis A
Are HIV positive
Are experiencing homelessness
Have a clotting-factor disorder, such as hemophilia
Use any type of illegal drugs (not just those that are injected)

Complications

Unlike other types of viral hepatitis, hepatitis A does not cause long-term liver damage, and it doesn't become chronic.

In rare cases, hepatitis A can cause a sudden loss of liver function, especially in older adults or people with chronic liver diseases. Acute liver failure requires a stay in the hospital for monitoring and treatment. Some people with acute liver failure may need a liver transplant.

Prevention

The hepatitis A vaccine can prevent infection with the virus. The vaccine is typically given in two shots. The first one is followed by a booster shot six months later.

The Centers for Disease Control and Prevention recommends a hepatitis A vaccine for the following people:

All children at age 1, or older children who didn't receive the childhood vaccine
Anyone age 1 year or older who is experiencing homelessness
Infants ages 6 to 11 months traveling internationally
Family and caregivers of adoptees from countries where hepatitis A is common
People in direct contact with others who have hepatitis A
Laboratory workers who may come in contact with hepatitis A
Men who have sex with men
People who work or travel in parts of the world where hepatitis A is common
People who use any type of illicit drugs, not just injected ones
People with clotting-factor disorders
People with chronic liver disease, including hepatitis B or hepatitis C
Anyone wishing to obtain protection (immunity)

If you're concerned about your risk of hepatitis A, ask your doctor if you should be vaccinated.

Follow safety precautions when traveling

If you're traveling to parts of the world where hepatitis A outbreaks occur, take these steps to prevent infection:

Peel and wash all fresh fruits and vegetables yourself.
Don't eat raw or undercooked meat and fish.
Drink bottled water and use it when brushing your teeth.
Avoid all beverages of unknown purity, with or without ice.
If bottled water isn't available, boil tap water before drinking it.

Practice good hygiene

Thoroughly wash your hands often, especially after using the toilet or changing a diaper and before preparing food or eating.

Diagnosis

Blood tests are used to look for signs of the hepatitis A virus in your body. A sample of blood is taken, usually from a vein in your arm. It's sent to a laboratory for testing.

Treatment

No specific treatment exists for hepatitis A. Your body will clear the hepatitis A virus on its own. In most cases of hepatitis A, the liver heals within six months with no lasting damage.

Hepatitis A treatment usually focuses on keeping comfortable and controlling signs and symptoms. You may need to:

Rest. Many people with hepatitis A infection feel tired and sick and have less energy.
Manage nausea. Nausea can make it difficult to eat. Try snacking throughout the day rather than eating full meals. To get enough calories, eat more high-calorie foods. For instance, drink fruit juice or milk rather than water. Drinking plenty of fluids is important to prevent dehydration if vomiting occurs.
Avoid alcohol and use medications with care. Your liver may have difficulty processing medications and alcohol. If you have hepatitis, don't drink alcohol. It can cause more liver damage. Talk to your doctor about all the medications you take, including over-the-counter drugs.

Lifestyle and home remedies

You can take steps to reduce the risk of passing hepatitis A to others.

Avoid sexual activity. Avoid all sexual activity if you have hepatitis A. Many kinds of sexual activity can spread the infection to your partner. Condoms don't offer adequate protection.
Wash your hands thoroughly after using the toilet and changing diapers. Scrub vigorously for at least 20 seconds and rinse well. Dry your hands with a disposable towel.
Don't prepare food for others while you're actively infected. You can easily pass the infection to others.

Preparing for an appointment

If someone close to you is diagnosed with hepatitis A, ask your doctor or local health department if you should have the hepatitis A vaccine to prevent infection.

If you have signs and symptoms of hepatitis A, make an appointment with your family doctor or a primary doctor.

What you can do

Because appointments can be brief and there's often a lot of information to cover, it's a good idea to be well-prepared.

Be aware of pre-appointment restrictions. When you make the appointment, find out if there's anything you need to do in advance, such as change your diet.
Write down your symptoms. Include those that seem unrelated to the reason for your appointment.
Write down key personal information, including major stresses or recent life changes.
List medications, vitamins and supplements you take.
Consider taking a family member or friend along. Someone who accompanies you may remember something that you missed or forgot.
Write down questions to ask your doctor.

Listing questions for your doctor can help you make the most of your time together. For hepatitis A infection, some basic questions to ask your doctor are:

What is likely causing my symptoms or condition?
Other than the most likely cause, what are other possible causes for my symptoms or condition?
If I have hepatitis A, what can I do to keep from infecting others?
Should people close to me receive the hepatitis A vaccine?
Can I continue to work or go to school while I have hepatitis A?
What are the signs and symptoms of serious hepatitis A complications?
How will I know when I can no longer spread hepatitis A to others?
Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

When did your symptoms begin?
Do you have symptoms all the time, or do they come and go?
How severe are your symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to make your symptoms worse?